American Journal of Obstetrics & Gynecology
Volume 197, Issue 4 , Pages 409.e1-409.e6, October 2007

A population study of the contribution of medical comorbidity to the risk of prematurity in blacks

Presented at the 27th Annual Clinical Meeting of the Society for Maternal–Fetal Medicine, San Francisco, CA, Feb. 5-10, 2007.

  • Deborah B. Ehrenthal, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Christiana Care Health Services, Newark, DE
    • Corresponding Author InformationReprints: Deborah Ehrenthal, MD, Room 1905, Women’s Health Building, Department of Obstetrics and Gynecology, Christiana Care Health System, 4755 Ogletown-Stanton Road, Newark, DE 19718
    • ,
  • Claudine Jurkovitz, MD, MPH

      Affiliations

    • Christiana Care Center for Outcomes Research, Christiana Care Health Services, Newark, DE
    • ,
  • Matthew Hoffman, MD, MPH

      Affiliations

    • Department of Obstetrics and Gynecology, Christiana Care Health Services, Newark, DE
    • ,
  • Charlan Kroelinger, PhD

      Affiliations

    • Delaware Division of Public Health, Dover, DE.
    • ,
  • William Weintraub, MD

      Affiliations

    • Christiana Care Center for Outcomes Research, Christiana Care Health Services, Newark, DE

Received 12 March 2007; received in revised form 2 May 2007; accepted 16 July 2007.

Objective

The purpose of this study was to test the hypothesis that the higher prevalence of medical comorbidities among black women accounts for their increased risk of prematurity.

Study Design

A population-based regional cohort of women receiving obstetric care for singleton pregnancies at a large community hospital between 2003 and 2006 were analyzed using univariate and multivariable logistic regression.

Results

Data for 18,624 consecutive births found increased odds of adverse outcomes for black compared to white women: prematurity OR = 1.6 (1.4-1.8), extreme prematurity OR = 2.5 (2.0-3.2). Logistic regression modeling identified black race, age < 20, preconception diabetes and hypertension, smoking, underweight, and gestational hypertension as the greatest risks for adverse outcomes. Controlling for these risks did not attenuate the higher risk for prematurity among blacks.

Conclusion

Though there is a greater burden of health risk among black women, this did not account for the higher rates of low birthweight and prematurity.

Key words: health disparities, low birthweight, preconception health, prematurity

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 Cite this article as: Ehrenthal DB, Jurkovitz C, Hoffman M, et al. A population study of the contribution of medical comorbidity to the risk of prematurity in blacks. Am J Obstet Gynecol 2007;197:409.e1-409.e6.

PII: S0002-9378(07)00882-4

doi:10.1016/j.ajog.2007.07.015

American Journal of Obstetrics & Gynecology
Volume 197, Issue 4 , Pages 409.e1-409.e6, October 2007

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